Universal health care

Saab wrote:

quote:
Sweden has very good doctors and hospitals, but there is often a long waiting list to get into them. About 10-15 years ago the average patient had to wait 5 years for an operation. Things are changing as the different hospitals are cooperating..
Now it is only a few months if you are lucky. Cancer usually get operated as fast as possible. New hip can take months.
As far as I know many Swedish doctors like to work in Norway, better paid and less paperwork.
end of quote---
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"Now, it is only a few months if you are lucky".

My aunt needed a gall bladder removed. She did not like the Doctors she consulted on a Monday. Wednesday, she called the Mayo Clinic in Rochester, Minnesota. She had her Gall Bladder removed the next Tuesday.

Her out of pocket cost( since she was a retired teacher with Blue Cross Blue Shield Coverage and Medicare) was $158.23.

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In Canada, a person who was waiting for a hip replacement and. allegedly, suffering greatly( a wait that was more than a year when he sued), was vindicated by the Canadian Supreme Court which ruled that he indeed had the right to purchase Individual Insurance OUTSIDE of the Canadian Health System.

The Canadian Health System is not trusted by Canadians who are able to afford care in other countries. Indeed, a high ranking Canadian Official went to the State of Florida to have a heart valve repaired. That speaks volumes about the Canadian System!

Yes, but. . . . You know that at least one Mayo facililty in Arizona has stopped accepting Medicare at its primary care operation? They do still accept it for specialists.

Cyracuse wrote:


I can see how it is hard for someone who is raised with selfishness as the prime ideal to come around to the idea of a society that takes care of it's weakest and most unfortunate.
end of quote
I really don't know what you mean about "selfishness".

The US gave tons of money to almost any country that needed help in case of disasters( See Haiti as a prime example)

The US has always been a country that believes in market-"laissez faire"

The US is not Norway. I believe Norway has about five Million people.
The US holds over 300 Million.

Norway has very few minorities. The US is loaded with minority people, some of whom were, very unfortunately brought to the US as slaves. These people were freed during the civil war but some people believe that the attitudes of racists still militate against a fair shake for African-Americans.

I think I might be tempted to lead towards a more centralized system of Medical Care if I were in a country as small and homogeneous as Norway. However, te Norwegian system would never work here because there are so many people who do not have the ability, information or motivation to keep themselves as healthy as I am sure the Norwegians do.

Yes, I know that. But that is not the case in Rochester, Minnesota. However, if you know the details, there is no large problem occuring in Arizona- Mayo Clinic.

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Medicare
Medicare pays for much of a patient's health care " but not all of it. Your out-of-pocket expenses depend on whether your doctor or supplier of health-care equipment and supplies agrees to "accept assignment" (the Medicare approved payment amount).

Medicare Basics at Mayo
While Mayo Clinic provides medical services to Medicare patients, Mayo has chosen to be nonparticipating and thus does not accept assignment from Medicare for professional and physician services. By not accepting assignment, it means that Mayo does not accept the Medicare approved payment amount as full payment. Mayo follows an established fee schedule based on the federal guidelines for Medicare patients allowing health-care organizations to charge up to 15 percent above the Medicare allowable for which you are financially responsible.

This is how it will affect you:

Example of Medicare Basics at Mayo
Mayo Clinic charge $115.00
Medicare approved amount $100.00
Medicare pays you 80% of approved amount $ 80.00
Secondary insurance pays 20% of approved amount * $ 20.00
Total paid by Medicare and secondary insurance $100.00
Patient responsibility $15.00

*The secondary insurance reimbursement may vary depending on the patient's Medigap policy. Some policies may cover additional charges than in the example. For more information, please visit the Medicare Web site to review the publication titled Choosing a Medigap Policy.

Are there services for which Mayo Clinic must accept assignment from Medicare?
Yes. Those services are:

•Mayo Clinic Hospital facility charges
Example: Room and board, operating room, some drugs
•Laboratory tests covered by Medicare
•Physician Assistant services
•Nurse Anesthetist services
•Ambulatory Surgery Center chargE

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Doctors not accepting Medicare? Horrors!! Yes, it is true. Some Doctors in the USA, which is still free from the Socialism of Obamacare, opt not to accept Medicare because they feel that Medicare does not pay them at a level commensuate with their professional skills.

But, wait--wait--wait--If you have read Obama's plan carefully, you will find that some of the SAVINGS that Barack Hussein Obama has promised us will come from CUTS( yes, CUTS) in Medicare. Every year, the Senate has pondered making those CUTS, but they have always restored the CUTS proposed. The Congress must now make those cuts or Obamacare will( gasp) not be revenue neutral. It will be overbudget despite the fact that most of its provisions will not kick in till 2014.

Americans who do not know this will be shocked when it happens. Their doctors will explain to them that since their Medicare payments were cut they must charge them more money out of pocket!

MASSAGAT said



What on earth does that comment have to do with the notion of providing universal health care in the U.S.?

MASSAGAT, forget Obamacare and forget health care in other countries for just a minute. Are you opposed to the concept of universal health care coverage in any form?

I am very sorry, firefly, perhaps I did not express my self adequately.

Again-Norway has 5,000,000 people. The US has 300.000,000 people.

Norway has few minorities. The US has many minorities.

Norway's population is rather homogeneous. The US population is NOT
homogeneous.

African-Americans and newly arrived Hispanics, probably because of the bigoted attitudes of many Americans who have been here for years, do not have, according to Jesse Jackson, Al Sharpton and others, ADEQUATE health care.

Are we then to conclude that the Americans who have saved all of their lives, hold good insurance policies, wish to keep their present doctors, do not want to see insuance premiums go sky high, and, are opposed to the use of a limited resource, by people who have broken the law by entering the US without permission?

There must be a solution!!!

Certainly-- I agree--But it is not called UNIVERSAL Health Care.

The solution is found, in my opinion, in taking one problem at a time and solving it instead of radically changing basic US Health Care.

Should people with pre-existing conditions be allowed to be covered by insurance? Of course, and there is no problem with the Congress carefully crafting a bill that accomplishes that--even if it means an added tax on the rest of the country.

Most of the problems can be attacked one at a time. But there should be NO COMPLETE TAKEOVER OF THE US HEALTH SYSTEM BY THE LEFT WING SOCIALISTS IN DC.

England and Canada, which are more like us than tiny Norway, have Health Care systems which are disasterous. Would you like to have some evidence of that?

MASSAGAT, to some extent, I think you are confusing issues of ethnicity and race with problems associated with economic class or socio-economic level.

African Americans and Hispanics comprise a disproportionate percentage of the unemployed. That does not mean that there are not wealthy people, middle class people and working class people among African Americans and Hispanics, because there are. But, among those living at the poverty level, or below, African Americans and Hispanics are disproportionately represented--for many reasons. The unemployed may not have any health care coverage. Those who are most impoverished might qualify for Medicaid. It has always been the case that the poor have often received inadequate medical care. That was the group that Jackson and Sharpton were referring to, not all African Americans and Hispanics. It primarily is an issue of economic class (and social power), not one of race or ethnicity. And I believe that Jackson and Sharpton were not entirely happy with the bill just passed because it did not address existing problems in health care delivery to poor minorities.

And, MASSAGAT, who is advocating that we provide health care coverage to those who are in this country illegally? I believe such people are specifically excluded from coverage under existing programs, and in the bill that was just passed.

The problem, with regard to health care, is not that we have a diverse population, which includes many minorities, but that we have many people with no health care coverage because they are unemployed, or only employed part time, or can't afford the cost, or are refused coverage, etc. These problems affect all racial and ethnic groups in the country, not just minorities. They affect not just the poor, but also the working class, the middle class, the upper middle class, and just about everyone who is not extremely wealthy, because the costs of health care can be extremely high, particularly for a catastrophic illness. And the effects of the current recession have exacerbated this situation because of the loss of jobs.

Even people who are employed, and have health care coverage, may find that their out of pocket medical costs are too high because certain treatments or medications are not covered, or not fully covered, or because of other denials by their insurance carriers, or because they have maxed out the cap on their coverage.




The info above isn't exactly positive encouragement to continue our private health care system in it's current form.

I think we do need universal health care, but I feel we need a public option to compete with the private sector. We already have government sponsored medical care with Medicare, Medicaid, and the V.A., and these options have helped to keep costs down, while providing health care to millions and millions of people. And we have not turned into a socialist economy because of that. Expanding Medicare, or allowing people to buy into a Medicare-type public option would be one alternative. People could still buy private insurance, or additional insurance (as they do with Medigap now), but at least you could assure some type of basic health coverage.

We need universal health care, just as we have universal public education. I really feel that both are necessary to insure the general welfare of a society. People can, and do, opt out of public education--they home school, send their children to private schools, parochial schools, etc.--but a public option is available. Similarly, the government can provide a public option in health care, but people can be free to opt out and choose a private alternative.

Obviously, I am not entirely happy with the health care bill which was just passed because it did not include a public option. I hope a public option will be implemented in the future.

And MASSAGAT, because your aunt was able to choose where to have fairly fast gall bladder surgery (partly paid for by Medicare, a public option, and Medigap insurance, a private plan tied to a public option), really does suggest that public plans work. But your aunt is fortunate--she has insurance coverage. What about the at least 30 million people who don't have coverage? Or the people who have coverage, but go bankrupt paying medical bills?

With all the ranting about Obamacare, and socialism, and how awful health care is in Canada, isn't there any compassion for the people in this country who receive no medical care, or inadequate care? Isn't universal health care as much of a moral issue as an economic one? I don't hear very much about morality. And, MASSAGAT, the private health insurers, and the drug manufacturers, who have been dictating medical care in this country, certainly don't display a high enough sense of moralty, or of regard for consumers, to warrant a passionate defense of the status quo from anyone--they continue to reap exhorbitant profits while millions suffer from a lack of health care. The only way to improve the system requires a radical change.

Even Politifact rates as 'half true' the claim that 60% of bankruptcies are due to medical bills. They put the number at 29%.

That may be true since those 62% were reported as the result of a study in the August issue 2009 of The American Journal of Medicine.

On the other hand, I would consider even a one digit percentage for unbelievable.

Move.

Irishk, even 29% declaring bankruptcy, due to medical bills, would be too high. And, since bankruptcy is a last resort, many more would be financially overwhelmed by medical expenses and desperately struggling just to keep a roof over their heads and feed their children, just short of declaring bankruptcy. Or their homes have been foreclosed and they are essentially homeless without any assets left. All because an act of fate, a catastrophic illness, hit a member of the family.

And this study was done before the recession really hit, so, if anything the situation is worse now.

I do not find this situation acceptable in my country. We are better than that. We can, and should, devise a health care plan that at least provides some basic level of medical care for everyone, and some protection from the costs of chronic and catastrophic illness for everyone.

I'm not happy with the bill that was just passed, I think it needs a lot of improvement. But I think we are capable of devising a system which will work, and one that does not sacrifice the interests, and lives, of ordinary people to the financial interests, and whims, of private insurance companies. And I don't think we need a complete government takeover of health care to accomplish that.

When we talk about health care, we are talking about matters of life and death. I don't notice too many people objecting to the fact that the government (in the form of the FDIC) protects their money in a bank. Should the government not try to protect the lives and the health of it's citizens with a similar form of oversight and control regarding health care? Is protecting money more important than protecting peoples lives?

I don't want the government involved in every aspect of life, but I do want them to insure the general welfare of our population. I do think they have a moral obligation to insure and facilitate some system of universal health care in our country. And I don't think this should be a partisan issue. The problem is, it has become a partisan football. Doing nothing to correct the serious flaws in our health care system, or just applying band aids to hemorrhaging wounds, has not worked. We do need a different, better, approach, If the current bill isn't the best way to correct the problem, then we need to improve it until we can hammer out something that will work well. But our goal should be some sort of universal coverage, and better protection from the financial ravages of serious illness.

Firefly wrote:

The problem, with regard to health care, is not that we have a diverse population, which includes many minorities, but that we have many people with no health care coverage because they are unemployed, or only employed part time, or can't afford the cost, or are refused coverage, etc. These problems affect all racial and ethnic groups in the country, not just minorities.

end of quote

Firefly---Healthy people don’t need significant healthcare coverage. Sick people do. It is entirely illogical (not to mention unconstitutional) to require private entities to insure someone against something they already have at the same price. They have it. They are now inherently riskier.

Setting aside - you know, freedom - someone has to pay for free insurance to sick people who were uninsured. The result will be an individual mandate because you must increase the number of healthy people in the risk pool to even ATTEMPT to pay for such coverage, and because if you don’t have a mandate, it’s obvious that people will simply wait until they are sick and then get coverage.

This isn’t that hard - yet everyone walks around acting like it’s magic. The goal for anyone who values both high quality healthcare and freedom is to make sure that as many people as possible are covered BEFORE they are sick. And Republicans have numerous proposals to accomplish this goal - to reduce costs and cover more Americans, and should not run from them. In the end, if some people cannot afford coverage - then we decide how to handle that problem, through the combined efforts of private enterprise, charity, local/state governments, and as a last resort - the national government… something, I might add, we already have.

And, if you have read carefully, firefly, the Obamacare Mandate is in trouble and is being sued.

Firefly wrote:

When we talk about health care, we are talking about matters of life and death. I don't notice too many people objecting to the fact that the government (in the form of the FDIC) protects their money in a bank.

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Taxpayers pay for the FDIC, firefly. The Government is US, or have you forgotten that? The people of the USA do not, I repeat, do not, want Obamacare since it means, IN THE LONG RUN, governmental control of one sixth of the economy. i don't know how long you have lived, Firefly, but the government does almost nothing right. Obama signed a HUGE stimulus bill into law a YEAR AGO, firefly. Not even half of that stimulus bill has been spent, firefly, Bureaucratic holdups, firefly. If and When Obamacare is full blown, your health care will have to be approved by some dimwitted functionaries in several government departments. Are you willing to wait?

If you don't believe that you would wait, educate yourself. I am sure that you can find DOCUMENTATION AND EVIDENCE on the Internet which shows how horrible Health Care is in England and Canada.

You are right. Things can be improved. And, I should have a Rose Garden. But my father said--"I never promised you a Rose Garden.

There is no Utopia, firefly. There is always a tension between freedom and equality. if people are more equal, more people will be less free since in a Constitutional Republic as we have, only "redistribution of resources" as advertised by Obama will make people more "equal" but, it will also cutail the freedom of others.

We shall see what the courts say about that when the suit of the State AG's concerning the constitutionality of forcing people to buy insurance is adjudicated.

Why do people go "bankrupt". Irishk? I am sure that in some instances of the 29% you gave, health expenses ARE NOT the only reason for bankruptcy. Moral superiority adheres to "bankruptcy" whereas none is attached to heavy payment on homes that they never should have bought, autos which were beyond one's means, gambling debts, heavy expenditures for useless items.

How many people have cable TV, Irish K?

My aunt never made a great deal of money. She was never in the group above 25% of the population with regard to income. Yet, and because she saw herself as being responsible, she insisted on paying a high premium for top rated insurance as well as a stiff payment for Nursing Home Insurance. And, IrishK, she never had Cable TV.

But all people are potentially sick people. Do you know if you will develop cancer next week? Do I? That's also the risk that the insurers take on--that's why people have, and need, insurance, to protect against what you can't foresee, what might happen.

A lot of the people already insured are healthy people. A lot of the people who lack health insurance are also healthy people. If all people have to be covered by insurance, we will have a large percentage of insured healthy people...at least until they start getting sick.

We do have to mandate it, but I think I'd rather see that done by attaching it to social security (which is how I think they do it in France), to at least fund a public option. There really is no free insurance with the Medicare model. People pay into Medicare throughout their working lives, and continue paying even after going on Medicare, if they work beyond age 65. In addition, the cost of Medicare Part B comes out of monthly social security benefits (or is paid directly to the government), Part D prescription coverage is purchased and paid for separately, and, if one wants increased medical coverage, a Medigap policy is privately purchased (at about a premium cost of $199-275 per month). So, Medicare isn't free at all, but it is affordable and it provides excellent coverage with freedom of choice for the patient. Medicare also helps to control health care costs.

What I'd like to see is an expansion of Medicare, or a Medicare-like model available as a public option, with everyone having to contribute something into it, whether or not they choose to use it as their coverage prior to age 65. But I'm sure that people who know more about such things than I do, could come up with even better ideas. We do have to get everyone accustomed to the idea that everyone has to begin paying for health care, and we have to make it affordable and available to everyone.

I'm not strongly defending the current health care bill, because there is a lot I don't like about it. But I am happy we finally have a bill, because I see it as the initial step toward universal health care coverage. Did the Republicans ever present health care reform legislation when they were in the majority and their man was in the White House? I don't see them as really committed to the notion of reform. And I'm also tired of talking about this issue from a totally partisan perspective, or even in terms of what's wrong with Obamacare. Obamacare is just a first step. I think we have a long way to go before we really get it right.

MASSAGAT, at least 29% of the cases of bankruptcy are due to overwhelming medical bills, and that's probably a conservative estimate because the study was done before the recession hit, and the study actually suggested that 62% of bankruptcies were due to medical costs.

You seem totally out of touch with the real costs of medical care for a catastrophic illness--even for people who do have insurance. And very ill people often cannot work, they lose their jobs, and consequently lose their health care coverage. Go back a few posts, to the study and re-read it. These aren't people who are blowing their money on other things, they are people who are hit with astronomical medical bills.

If you really don't understand what is going on with medical care in this country, and how out of control costs are, you really shouldn't be so fast to criticize attempts to reform the system, or to propose "fixes" which fail to address some of the root causes of the problem.

We need a health care system that will provide basic coverage to all, and coverage that will be there for people when they need it the most.

Firefly--Please read the report below:


July 30, 2009
The Healthcare Bankruptcy Myth
By Diana Furchtgott-Roth

Few figures in American life have suffered as publicly as Elizabeth Edwards, a cancer survivor whose son was killed in a car accident, the betrayed wife of presidential candidate John Edwards. Like a classic Greek heroine, she has only one flaw: she is too trusting. This week, she was duped into endorsing a flawed bankruptcy study that was transparently intended to support a single-payer health care plan.

In testimony before a subcommittee of the House Judiciary Committee, Mrs. Edwards declared, "Medical debt is, of course, a symptom of larger problems in our health care system-and the solution to medical debt and medical bankruptcy is real health reform that results in affordable, reliable health coverage and affordable health care for all Americans."

Mrs. Edwards based her testimony on a study in the American Journal of Medicine conducted by Dr. David Himmelstein and other researchers from Harvard University and Ohio University. An unassuming reader might conclude that medical debts are the major cause of personal bankruptcy in America, because the study finds that 62% of bankruptcies in 2007 were "medical."

House Judiciary Chairman John Conyers of Michigan, who should know better, said "This surge in medical bankruptcies demonstrates why health care reform is urgently needed right now. So many people's lives are uprooted, and their financial security destroyed, by unexpected medical costs."

But fewer than one percent of Americans enter bankruptcy each year. Of those, only three to five percent are plausibly bankrupt due to medical debt. These numbers present the inconvenient truth that our health system is not leading to bankruptcy in America.

The Himmelstein study paints a picture of an American middle class that even with health insurance coverage is being bankrupted by health care costs. The share of bankruptcies attributable to health care costs rose by 50%between 2001 and 2007, according to the study. The message is that rising health care costs bankrupt the insured middle class as well as the uninsured lower class.

The only problem is that the study is fatally flawed. Dr. Himmelstein is a co-founder of Physicians for a National Health Program, an organization that describes itself on its Web site as "the only national physician organization in the United States dedicated exclusively to implementing a single-payer national health program." An additional Harvard coauthor, Dr. Steffie Woolhandler, is co-founder and secretary of the organization. Even though the article states on the front page that the authors have no conflict of interest, two are self-declared activists for single-payer health care, and they have twisted the data to fit their cause.

Aparna Mathur, an American Enterprise Institute research fellow and another witness in the hearing, told me in a telephone conversation that "the Himmelstein surveys overstate the effect of medical debts on bankruptcy. Despite obvious problems with the survey methodology, it was clear to me during the testimony yesterday that the study was being used as a pretext for making the case for universal health insurance."

Dr. Himmelstein's study contradicts the economics literature on personal bankruptcies. Most reputable studies are based on the Survey of Consumer Finances, published by the Federal Reserve, which lists different types of consumer debt. Medical debt rose slightly from 5.5% of all debt in 2001 to 5.8% of all debt in 2007, according to the Fed.

A study by the Department of Justice examined more than 5,000 bankruptcy cases between 2000 and 2002. It found that 54% of bankruptcies involve no medical debt, and more than 90% have medical debt of less than $5,000. Even among the minority of bankruptcies that report medical debt, only a few have enough to cause personal bankruptcy.

Dr. Himmelstein gets different results because he uses a smaller sample and a different methodology than other studies. He started with a random sample of 5,251 bankruptcy petitions and wound up through a series of screenings only using 1,032. His survey assumes that when a medical problem is mentioned that associated medical costs are automatically associated with bankruptcy. In addition, anyone is counted as medically bankrupt if they cite illness or medical bills as a reason for bankruptcy, even if other debts, such as foreclosure and credit card debt, are a primary reason.

Furthermore, if respondents lost two weeks of work due to illness or injury they were counted as medically bankrupt, even if they had no medical debt. Hypothetically, someone could go into bankruptcy while on Medicare or Medicaid, even if they owed no medical bills at all.

Yet using Dr. Himmelstein's methodology, even single-payer health care would not solve the medical bankruptcy problem. People would still lose work time to illness, perhaps even more time than under the current system, because health care would be of lower quality. Under Britain's single-payer system, for example, people who think they might have swine flu are not being seen by doctors. Instead, they are asked to stay home and consult with the doctor over the phone.

More and more Americans understand that adding $1 trillion to government spending for health care reform won't fix our economic crisis. So proponents of single-payer health care bring out poor Elizabeth Edwards to justify their made-up numbers on medical bankruptcy. Shame on them.

Firefly--especially note the following:

But fewer than one percent of Americans enter bankruptcy each year. Of those, only three to five percent are plausibly bankrupt due to medical debt. These numbers present the inconvenient truth that our health system is not leading to bankruptcy in America.

1% equals 3 Million.

3 to 5% of 3 million equals 100,000 at the most. I am in favor of covering those people. Give each valid bankrupt $5 0,000. This is a pittance and would equal five billion. Take it out of the thirty or forty billion unspent and failed Stimulus Package pushed by Obama.

Please note-firefly-

A study by the Department of Justice examined more than 5,000 bankruptcy cases between 2000 and 2002. It found that 54% of bankruptcies involve no medical debt, and more than 90% have medical debt of less than $5,000. Even among the minority of bankruptcies that report medical debt, only a few have enough to cause personal bankruptcy.

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You want to ruin the economy of the USA and hand one sixth of the national yearly GDP to the bureaucrats in DC who have NEVER run anything successfully?

Please!

Firefly wrote:

We do have to mandate it, but I think I'd rather see that done by attaching it to social security (which is how I think they do it in France), to at least fund a public option.

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You're joking, aren't you? You know that Social Security will soon be paying out more a year than it is taking in due to the rfetirement of the Baby Boomers.
The people who are identified as Baby Boomers were born from 1946 onward.
The 46'ers will turn 65 next year.


Social Security will officially be bankrupt in 2042. By 2017 a majority of the "baby boomers" will be receiving social security benefits and due to the population and labor force growth slowing down the Social Security Administration will be paying out more than they are receiving in through taxes and other means. Currently there is a 16-member commission to strengthen social security. The commissions website: http://www.csss.gov/

Now, maybe we can save Social Security but adding Health Care to it? Out of the financial question!